1. Field of the Invention
The present invention relates to medical methods and systems. More particularly, the invention relates to a method and system for physiological gating of radiation therapy.
2. Background
Radiation therapy involves medical procedures that selectively expose certain areas of a human body, such as cancerous tumors, to high doses of radiation. The intent of the radiation therapy is to irradiate the targeted biological tissue such that the harmful tissue is destroyed. In certain types of radiotherapy, the irradiation volume can be restricted to the size and shape of the tumor or targeted tissue region to avoid inflicting unnecessary radiation damage to healthy tissue. For example, conformal therapy is a radiotherapy technique that is often employed to optimize dose distribution by conforming the treatment volume more closely to the targeted tumor.
Normal physiological movement represents a limitation in the clinical planning and delivery of conventional radiotherapy and conformal therapy. Normal physiological movement, such as respiration or heart movement, can cause a positional movement of the tumor or tissue region undergoing irradiation. If the radiation beam has been shaped to conform the treatment volume to the exact dimensions of a tumor, then movement of that tumor during treatment could result in the radiation beam not being sufficiently sized or shaped to fully cover the targeted tumoral tissue.
One approach to this problem involves physiological gating of the radiation beam during treatment, with the gating signal synchronized to the movement of the patient""s body. In this approach, instruments are utilized to measure the physiological state and/or movement of the patient. For example, respiration has been shown to cause movements in the position of a lung tumor in a patient""s body. If radiotherapy is being applied to the lung tumor, then a temperature sensor, strain gauge, preumotactrograph, or optical imaging system can be utilized to measure the patient""s respiration cycle. These instruments can produce a signal indicative of the movement of the patient during the respiratory cycle. The radiation beam can be gated based upon certain threshold amplitude levels of the measured respiratory signal, such that the radiation beam is disengaged or stopped during particular time points in the respiration signal that correspond to excessive movement of the lung tumor.
Known approaches to physiological gating of radiation therapy are reactive, that is, known approaches utilize gating methods that slavishly react to measured levels of physiological movements. One drawback to reactive gating systems is that the measured physiological movement may involve motion that that is relatively fast when compared to the effectively operating speeds of gating system components. Thus, a purely reactive gating system may not be able to react fast enough to effectively gate the applied radiation. For example, the gating system may include a switch for gating the radiation treatment, in which the switch requires a given time period xcex94t to fully engage. If the switching time period xcex94t is relatively slow compared to the measured physiological motion cycle, then a system employing such a switch in a reactive manner may not be able to effectively gate the application of radiation at appropriate time points during the radiation therapy.
Therefore, there is a need for a system and method to address these and other problems of the related art. There is a need for a method and system for physiological gating which is not purely reactive to measure physiological movement signals.
The present invention provides an improved method and system for physiological gating for radiation therapy. According to an aspect, the invention comprises a method and system for detecting and predictably estimating regular cycles of physiological activity or movements. Another aspect of the invention is directed to predictive actuation of gating system components. Yet another aspect of the invention is directed to physiological gating of radiation treatment based upon the phase of the physiological activity.